Advances in Social Work

Fall 2022: Questioning the Status Quo

Margaret E. Adamek, Valerie Decker — Wed, 22 Mar 2023 00:00:00 -0400

In the Fall 2022 issue of Advances in Social Work, we are pleased to present 17 full-length papers (11 empirical, 6 conceptual) written by 52 authors representing all different regions of the country and one paper hailing from Ethiopia. The papers in this issue are organized into five areas of contribution: challenges to national social work organizations, technological innovations in social work, curriculum innovations, COVID-related impacts, and diverse client populations. Each paper is introduced briefly, followed by our annual recognition of AISW reviewers.

Missing the Mark?

Dawn Apgar, Mackaully Parada — Wed, 22 Mar 2023 00:00:00 -0400

The 2021 revision to the ethical code for social workers mandated engagement in self-care. A review of workforce data suggests that the need for self-care in social work is largely due to poor working conditions, inadequate pay, unavailability of quality supervision, and lack of professional recognition. Thus, making self-care largely a personal responsibility is adopting a “blaming the victim” mentality that the profession has historically rejected in its approach to client problems. Social work is rooted in examining the social conditions of people within their environments and focusing on making macro level changes to remedy systemic problems. Though not intentional, the ethical mandate for social workers to remedy the stress, trauma, and burnout resulting from environmental stressors is misplaced, though not surprising. In recent years, social workers have focused more on working with individuals to fix their problems rather than making contextual changes that are largely responsible for the ills. This article reframes the emotional and psychological problems experienced by social workers as a social justice issue, requiring mezzo and macro, rather than micro, level intervention. Embracing this alternative perspective requires a commitment to mobilization, advocacy, and political engagement—approaches that have been deprioritized by many within the social work profession.

Moral Reconation Therapy

Wed, 22 Mar 2023 00:00:00 -0400

Moral Reconation Therapy (MRT) is a manualized treatment commonly used in correctional settings to address perceived moral failing and associated problematic behaviors (e.g., substance use and criminal conduct). Many social work students are introduced to MRT as a treatment modality during field placements in correctional contexts. As a group modality that draws from cognitive-behavioral interventions and 12-step recovery programs, MRT has been touted as a cost-effective and evidence-based intervention. However, there are substantial reasons to question MRT’s appropriateness as an intervention taught to social work practicum students. Using several of the CSWE EPAS standards as guideposts, this paper addresses several key areas of concern with regard to the role of MRT in the training of social work students. Through our analysis of MRT’s curriculum, we identify areas of concern with regard to MRT’s ability to teach social work students how to ethically practice, engage diversity and difference in practice, or utilize research to inform practice. Despite the widespread use of MRT in correctional counseling contexts, we conclude that MRT is unsuitable for use in accredited social work field placements. Educators and accreditation agencies should critically evaluate the treatment models social work students learn and practice in field placements.

Information Communication Technology and the Social Worker-Client Relationship

Karen Randolph, Don Latham, Melissa Gross, Christopher Constantino — Wed, 22 Mar 2023 00:00:00 -0400

A core value in social work is the importance of the worker-client relationship. Communication is a key factor in this relationship. The pandemic, marked by a dramatic, rapid increase in communication through information communication technology (ICT), has underscored both challenges and benefits for the worker-client relationship. Informed by communication theories, this paper provides a conceptual framework for examining ICT interactions between workers and clients at the generalist practice level. The review revealed four challenges (e.g., more permeable worker-client boundaries) and five benefits (e.g., increased opportunities for social presence). Factors to be considered in guiding tool selection are: (1) communication medium “bandwidth”, (2) mutual directionality, (3) privacy and confidentiality, (4) message formality, and (5) complexity of message content. Implications for practice, education, and research emerged from this framework. For instance, increased methods of communication via technology can enhance social workers’ social presence in relating to clients. However, social workers must know how and when to use which tools. Finally, evidence is needed regarding how ICT use affects the worker-client relationship. Moving forward, we recommend applying communication theories to guide research on the impact of ICT on the worker-client relationship with the goal of establishing best practices for ICT use.

Media Use and Child Development

Samantha Bates, Aesha John — Wed, 22 Mar 2023 00:00:00 -0400

Social work practice with children and families is one of the largest specialization areas in the profession. To prepare students for this area of practice, social work programs often offer several courses focused on child, adolescent, and family well-being. Technology-related topics, however, such as the role of child and family media use on children’s developmental outcomes, are underrepresented in social work curricula, courses, and textbooks focusing on children and families. To highlight the importance of this content, our teaching note synthesizes evidence on the impact of two forms of media (television viewing and smartphone use) on children’s self-regulation and parent-child interactions. Although we focus on only two forms of media, our research synthesis links media use to emergent issues influencing child development and family functioning—content highly applicable to direct and indirect social work practice activities with children and families. We further draw upon our translational findings to advance social work education and practice by offering low- and high-effort strategies to embed this content in child and family social work courses. We conclude with implications and future directions for social work educators, practitioners, and leaders that describe opportunities to prepare students for a technology-driven future and to use technology strategically to fulfill our profession’s mission and values.

Benefits and Challenges of Telehealth Use during COVID-19

Wed, 22 Mar 2023 00:00:00 -0400

Social workers and other health care researchers have examined benefits and challenges of telehealth in rural communities before the COVID-19 pandemic. Yet, experience with virtual platforms and other technologies have rapidly evolved during the pandemic. The research team interviewed 14 health care providers and 17 patients after the onset of the pandemic in a predominantly rural state to examine perceptions of telehealth. MaxQDA analytic software was used to identify benefits and challenges in the use of telehealth. Findings identified commonly discussed benefits of telehealth including convenience for patients, increasing patient access to care, improved patient experience of care, and ability of telehealth to attract/retain patients. Challenges identified in this study included concerns about quality of care being compromised, patients’ comfort and access to technology, policy challenges for providers, and the impersonal nature of telehealth visits. Persistent issues warrant research, education, and policy advocacy to improve access for rural populations. Social workers should play a key role in educating the emerging and existing workforce around barriers such as quality of care and patient comfort with technology, convening professionals and patients to establish sustained and effective reimbursement models, and advocating for structural access via enhanced broadband and other resource allocations.

Increasing Social Work’s Stake in Interprofessional Practice

Amy Benton, Alejandro Allen, Lindsey Anderson, Erica Nason — Wed, 22 Mar 2023 00:00:00 -0400

Integrated behavioral healthcare is becoming increasingly important and central to social work practice as the healthcare field shifts from a solely disease model of health to a more holistic approach. Researchers have also noted the need for studies demonstrating effective models for incorporating integrated healthcare training into schools of social work. Studies that demonstrate the effects of integrated training have the potential to provide legitimacy to these training programs, an important step in furthering their adoption within schools of social work in the United States and abroad. The training program described here was designed to increase the number of MSW social workers who provide trauma-informed, culturally relevant, evidence-based behavioral health prevention and intervention practices at integrated healthcare settings. This study used a pre- and post-survey design with non-participating MSW students as a control group. Findings indicate significant increases in knowledge, skills, and attitudes for training participants. A recommendation for further research is to explore to what extent graduates transfer their enhanced knowledge to the workplace.

Are Social Work Students Being Adequately Prepared to Intervene With Suicide?

Rebecca G. Mirick — Wed, 22 Mar 2023 00:00:00 -0400

Suicide is a major public health issue in the United States, but it is unknown how many social work programs have courses specializing in this topic. The purpose of this study was to establish baseline knowledge of suicide-focused course offerings in social work programs in the United States. A survey of CSWE-accredited programs (n=151) in the United States was used to collect data on social work programs’ suicide content in their curricula at three levels: baccalaureate, graduate, and continuing education. While only 6% of programs offered a required course on suicide, 13.9% offered an elective focused on suicide, and courses with substantial suicide content were available in 25.2% of programs. Continuing education offerings with a focus on suicide were present at 26.5% of programs. The implications for social work education are discussed, including the need for more courses specializing in suicide, especially within MSW programs, and for future research to better understand the factors which limit the development of such courses.

Enhancing Student Commitment to the Micro-Mezzo-Macro Continuum

Mary Twis, Don Greenwood, Morgan Files — Wed, 22 Mar 2023 00:00:00 -0400

Despite the importance of macro practice to the social work profession, research related to social work students’ preparation and enthusiasm for macro practice suggests that there is significant room for improvement within macro social work education. The purpose of this report is to describe and explore a novel macro social work pedagogy that is designed to encourage student engagement within macro practice social work courses. The Macro Practice Assignment (MPA) offers students a real-world learning exercise with embedded micro, mezzo, and macro social work applications with one vulnerable population. The results of a multiple case study exploring the effectiveness of the MPA reveals that the MPA 1) reduces students’ negative perceptions of macro practice courses and careers, 2) fosters students’ interest in future macro practice, and 3) helps students see macro practice as a necessary component of the micro-mezzo-macro practice continuum. In order to address shortcomings in macro social work education, educators should consider adding real-world macro practice learning exercises such as the MPA, grounded in Bloom’s Taxonomy, with the goal of enhancing social workers’ lifelong commitment to macro practice.

Assessing the Impact of COVID-19 on Social Work Students

John M. Keesler, David Wilkerson, Kurt White, Stephanie Dickinson — Wed, 22 Mar 2023 00:00:00 -0400

COVID-19 had a profound impact on teaching and learning at academic institutions across the globe. This study examined the experiences of social work students (n = 884) during the pandemic and their associated level of burnout. Using a mixed methods approach, data from an online survey within a school of social work at a large Midwestern university were examined using stepwise regression and thematic analysis. Student demographics, academic characteristics, and experiences with COVID-19 were examined as predictors of burnout. Resilience was tested as a moderator of the association between COVID-19 experiences and burnout. Regression models accounted for 34.3% to 45.5% of variance across three domains of burnout (i.e., exhaustion, cynicism, and professional/academic efficacy), with COVID-related experiences accounting for most of the variance. Although resilience had a significant main effect, the interactions of resilience and COVID-19 experiences were not significant. Quantitative results were illuminated by thematic analysis of the qualitative data from which emerged four major themes: online teaching pedagogy, impact of COVID-19, transition of teaching and learning, and affective domains of learning. Engaging in humanistic education is discussed as a possible approach to circumvent burnout, bolster student resilience, and encourage academic success.

Stress During the Early Months of COVID in the U.S.

Jill M. Chonody, Barbra Teater, Katrina Hannan, Katelyn Hall — Wed, 22 Mar 2023 00:00:00 -0400

The stress that the COVID pandemic has caused is immeasurable and is likely to impact people for many years to come. Service providers such as social workers are experiencing these impacts both personally and professionally. As new research emerges, a greater understanding of the emotional toll related to COVID can help to inform social work practice. To add to this gap in the literature, an online survey explored the factors that contribute to higher stress reactions among individuals in the general population (n = 412) and across the age spectrum. Bivariate analyses indicated a significant increase in stress from pre- to during-COVID for the entire sample and across the three age groups. Multivariate analysis revealed more conversations about COVID, more alcohol use, knowing someone who had tested positive, increased fear, greater avoidance of reading/watching information about COVID, decreased health status, and increased income contributed to stress during-COVID. Increased fear and decreased health status were significant when stress was examined separately among the three age groups. The results indicated the importance of understanding and responding to fear during public health crises and illustrate how interventions may shift for clinical social workers as they seek to address multi-layered concerns. Social workers can help manage the impact of the pandemic by providing clients with therapeutic services, psychoeducation, and case management.

Responding to Adverse Childhood Experiences

Chan Hellman, Angela B. Pharris, Ricky Munoz — Wed, 22 Mar 2023 00:00:00 -0400

Research has long supported that Adverse Childhood Experiences (ACEs) are linked with reductions in well-being across the lifespan. However, less is known about the best practices for intervening with ACE to buffer the long-term negative effects beyond clinical settings. The current paper proposes that the positive psychology construct of hope offers guidance for understanding and responding to ACEs. We propose a theoretical model for developing a hope-centered and trauma-informed framework for responding to the deleterious effects for ACEs. The paper closes by calling on social work researchers, educators, and those in practice to learn more about the relationship between ACEs and hope and use that knowledge to help us better assist ACE survivors.

High-Achieving Asian American Adolescents and Suicide

Jessica Chock-Goldman — Wed, 22 Mar 2023 00:00:00 -0400

Within the field of suicidology, high-achieving Asian American adolescents are an under-researched at-risk population. The present paper reviews the existing literature on this topic, addressing the increase in suicidal ideation and suicide attempts within this at-risk group, and explores ecologically valid social work interventions. School social workers are first responders to these at-risk youth and must be well-versed in the risk-factors, including parental resistance to treatment, within the specific populations they serve. To illustrate the relevant issues, a case example is presented of an adolescent Bangladeshi male who attempted suicide while attending school. Finally, this paper recommends suicide prevention measures, including a culturally appropriate suicide assessment and family therapy.

“We Feel Powerless”

Gashaye Melaku Tefera — Wed, 22 Mar 2023 00:00:00 -0400

Gender-based violence (GBV), especially sexual violence with a 90% prevalence rate, is a top concern in humanitarian settings. This qualitative study explored the challenges and experiences of social workers in addressing Gender-based Violence (GBV) in Ethiopian refugee settings. In-depth interviews were conducted with eight social workers between the ages of 26-37 years who have had five to twelve years of experience in GBV prevention among refugees. Data were analyzed thematically using a codebook and Nvivo12 software. Three major themes emerged: power and political interest, institutional barriers, and strategic barriers. The Social-Ecological Model (SEM) was used to guide the discussion of the findings. Most of the challenges experienced by social workers were structural barriers emanating from the unbalanced power relationship and political interest between and within institutions, strategic/policy gaps, and organizational resource limitations. It is imperative that social workers are trained to function in a politically-sensitive practice setting and are prepared to embrace political activism to overcome structural challenges. Adopting anti-oppressive and integrated developmental approaches is recommended to resolve the complex socio-economic and political factors behind the widespread GBV acts in Ethiopian refugee settings.

International Student-Athletes' Psychological and Sociocultural Adjustment Experiences

Lauren Terzis, Lauren Beasley — Wed, 22 Mar 2023 00:00:00 -0400

International college students face psychosocial adjustment challenges transitioning into college, which may be heightened for international student-athletes (ISAs) who also have to adjust to Division I (DI) athletics. Even so, there are limited articles that synthesize the research on this population. Thus, we sought to fill this gap by examining studies focused on the adjustment experiences of ISAs. A qualitative interpretive meta-synthesis is a method used in social work research to synthesize the findings of qualitative studies (Aguirre & Bolton, 2014). We used qualitative interpretive meta-synthesis to conduct an exhaustive search of the literature, construct themes, and synthesize themes of qualitative research regarding ISAs and their adjustment experiences. We identified 11 articles with three overarching themes: (a) acculturative stress, (b) adjustment to the college experience, and (c) adjustment to athletics in the United States. Findings suggest ISAs experience not only transitional stress related to their identities as a student and as an athlete but also from their acculturation experiences. Thus, we propose ISAs transitioning to college experience a ternary-or three way-role negotiation of student identity, athlete identity, and cultural identity. Social workers employed at Division I institutions and within Division I athletic departments have the opportunity to advocate for the needs of this population.

Maltreatment and NICU Infants

JaNeen Cross — Wed, 22 Mar 2023 00:00:00 -0400

Child maltreatment is a concern for NICU infants who have special care needs at discharge. Improving mother-infant attachment through breastfeeding in a NICU environment may reduce maltreatment for this high-risk, vulnerable population. Breastfeeding an infant in the NICU is a complicated caretaking task yet provides an opportunity to overcome parenting challenges associated with a medically fragile infant by promoting the development of the maternal-infant attachment bond. Breastfeeding can serve as a prevention strategy for child maltreatment by improving attachment and bonding that is oftentimes disrupted between the NICU infant and mother due to the hospitalization. Social workers serve a pivotal role in preventing child maltreatment through education, promotion, and support of breastfeeding policies. This article highlights the role of social work in enhancing mother-infant attachment and advocating for NICU policies that support attachment therefore preventing maltreatment.

The Parents Divorcing Conflict Scale

Premela Deck, Sarah Eisensmith, Jacqueline Cafaro — Wed, 22 Mar 2023 00:00:00 -0400

Practical measures to screen for high levels of pre-divorce conflict offer a unique opportunity for early intervention by forensic social work professionals in divorces where children are at risk of being exposed to high levels of interparental conflict and subsequent maladjustment. There is a lack of validated short screening instruments specifically addressing pre-divorce conflict for parents with at least one minor child. An instrument of this nature would support those in the forensic social work field in identifying families that may be at risk for a high-conflict divorce process. Accordingly, this study describes the development of a self-report measure to assess conflict in parenting couples who are in the process of divorce. An Exploratory Factor Analysis (EFA) was conducted with data from a sample of parents in the process of divorce (n=114), and multiple factor structures were examined. The EFA confirmed that a one-factor model offered the best fit. The short 8-item Parents Divorcing Conflict Scale (PDCS) is a promising measure for use in forensic social work, research, and clinical and policy settings as it captures pertinent themes of conflict, including communication, social network, parent characteristics, satisfaction with agreements, and mistrust, and can inform early intervention strategies that will serve to support healthy communication practices amongst divorcing couples throughout the marriage dissolution process.